Q: Dr. Eppley, I have several keloid scars that need to be treated. I had a submental tuckup procedure done and at the same time had a mole on my chest removed. My submental tuckup procedure was done in an unconventional fashion as it included removing neck skin vertically and not just horizontally under the chin. I now have a wide and raised keloid scar on the vertical scar in the neck as well as the one on my chest. I have done some research and have read about the use of steroids with scar revision. Do you think this combined approach will work for me? I have attached some pictures of the scars in question.
A: In looking at your pictures what you have on your chest and neck are not keloids. Those are known as hypertrophic scars which are quite different biologically from a keloid which is a true pathologic derangement of scar formation. Hypertrophic scars often result in very predictable areas, such as the chest and vertically in the neck, due to the tension that is placed on the scar line. Treatment of hypertrophic scars is excision and reclosure, not steroids. Steroids will likely result in a recurrently wide but depressed scar as it interferes with collagen formation and wound healing. Steroids should only be used in true keloids that are recurrent and not hypertrophic scars. The location of your two scars in question places them in jeopardy for hypertrophic scar formation, even with scar revision consisting of repeat excision and closure. But this is still a worthwhile effort to do and improvement in the appearance of the scars is likely.
Dr. Barry Eppley